D'Alitto, Felicia; Scherz, Amina; Margini, Cristina; von Tengg-Kobligk, Hendrik; Montani, Matteo; Pabst, Thomas; Berzigotti, Annalisa (2018). Portal Hypertension and a Stiff Liver. Cureus, 10(6), e2768. 10.7759/cureus.2768
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Portal hypertension (PH) is a common clinical syndrome leading to severe complications. In the western world, about 90% of cases of PH are due to liver cirrhosis, and thanks to the availability of ultrasound elastography methods, this diagnosis is usually confirmed at bedside. We report a case of a patient presenting with PH and ascites initially suspected of suffering from liver cirrhosis. The finding of large hepatomegaly and a massive increase in liver stiffness prompted us to perform a liver biopsy. This revealed no fibrosis, but diffuse primary amyloidosis (AL amyloidosis). We discuss the diagnostic and treatment of this case, with emphasis on non-invasive imaging methods available for diagnosis and follow up.
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